PB2502: PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF BACTERIAL PATHOGENS ISOLATED FROM SICKLE CELL PATIENTS ADMITTED AT MRCG WARD FROM 2015 TO 2022
Authors: Alfred Amambua-Ngwa, Solomon Umukoro, Mustapha Dibbasey
Journal: HemaSphere (2023)

Topic: 26. Sickle cell disease Background: Invasive bacterial infections especially those caused by Streptococcus pneumoniae, Haemophilus influenzae type b, and non-typhi Salmonella species have been predominant cause of morbidity and mortality in sickle disease (SCD) patients (Williams et al. 2009). The Gambia has a well robust vaccination programme with the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in 2009 and then 13-valent PCV in 2011. Prior to introduction of PCV, Haemophilus influenzae type b (Hib) vaccine was introduced in 1997 (Grant Makenzie, 2021). Although the introduction of PCV into routine immunization schedules in the Gambia will be of benefit to all, it is likely to be particularly beneficial for children with sickle cell disease. Knowledge of the most common pathogens infecting patients with SCD could be used to improve antimicrobial prophylaxis and empirical treatment of infections. Aims: The aim is to provide an insight into prevalence of invasive bacterial infections in SCD patients admitted at the Medical Research Council the Gambia (MRCG) Ward in the era of PCV and Hib vaccine introduction in the Gambia and their microbial susceptibility pattern to guide the antibiotic prophylaxis treatment for the sickle cell patients. Methods: This study was conducted in the clinical laboratory department comprising of haematology, microbiology, and biochemistry laboratories. We retrospectively generated haematological and blood culture data from the electronic medical record system from 2015 to 2022 of the SCD patients admitted to MRCG Ward. From 380 sickle cell disease patients, blood culture was requested for only 159 SCD patients admitted to the Ward Results: We evaluated 159 admissions of SCD patients from January 2015 to July 2022 from the record, females accounting for 49.1% (78/159) and males accounting for 50.9% (81/159). From the 11 genuine positive blood cultures, 5 different types of pathogens were isolated from blood cultures comprising of Staphylococcus aureus 2.5% (4/159), Streptococcus pneumonia 1.9% (3/159), Salmonella species 1.3% (2/159), Enterococcus species 0.6% (1/159), and Shigella boydii 0.6% (1/159). No episode of bacteremia caused by Hib was identified in this study and one patient was serologed positive for hepatitis B. From this study data, we have seen penicillin resistance in two of the three Streptococcus pneumonia and all the Staphylococcus aureus pathogens isolated in blood culture. However, chloramphenicol, cloxacillin and vancomycin were sensitive to all the pathogens isolated. Summary/Conclusion:Streptococcus pneumonia and Staphylococcus aureus accounted for the most common cause of bacteremia in this admitted SCD patients. Antimicrobial resistance to penicillin was generally high in this study, highlighting reconsideration of penicillin prophylaxis and empirical treatment regimens for SCD patients. Keywords: Sickle cell disease, Sickle cell anemia, Sickle cell patient, Anemia